Resident Rotations

Oakland and Richmond service overview

During any given month, 4 to 5 residents are "on service" at Oakland. 

We have a lot of things to cover with few people, so you need to be flexible and help out where and when needed.

Rough resident schedule:

OAK faculty:

R1 rotations

***

R2 rotations

Allergy

1 month

Located near the Geary campus of Kaiser SFO, at 1635 Divisidero, Suite 101, 8-493-3780 or 415-833-3870

 

A month of pretty easy clinic (q1 hr patients with attending supervision), familiarizing yourself with medical management of allergic symptoms, skin testing and immunotherapy, as well as less relevant topics like asthma, urticaria, etc.  Dr. Strub is the coordinator and arranges lunchtime teaching sessions as well as your presentation at the end of the month.   Tuesday mornings are often free on this rotation.  If you plan on taking vacation on this rotation (as many of us do), please give them enough advance notice.

 

The other 3 months are all pretty flexible, absolve the R2 of rounding/scut and in general can be used to read more as well as scrub on more cases (esp tubes and tonsils days). 

Speech/Audiology

1 month

You will spend time with audiologists here at Oakland as well as a day a week at the Hearing Aid Center nearby.  Learn how audiograms are done as well as the finer points of interpretation.  In addition, they may also review other topics such as cochlear implant maintenance, hearing aid fitting, ENG testing, etc.  In years past, residents have been pulled off this rotation frequently to help the team - please respect the effort the audiologists have put into this rotation and try and do your best to work with them - they have a lot to offer.  This rotation has been combined with speech therapy where you will work with the STs in seeing their inpatient consults and their outpatient video stroboscopies or swallow evaluations. A good time to learn how to interpret these studies and see the other side of what you may refer a patient to.

Research

1 month

Utilize this time to work on your formal research project, usually your BARRS project, and potentially start on projects to be completed during the coming years.

The month is protected from call. However, you are still expected to attend all educational activities (Thursday morning conference, Temporal bone lab, Journal Club, etc.)

Of note, you may be asked to cover the OR 1-3 days per week. Consider the pros and cons of covering the OR versus completing research. Dr. Wang likes to have updates on how your research is going throughout your month and what you’ve completed. This is another good time to take vacation as well though keep in mind you still need to complete research during that time.

 

R3 Rotations

San Leandro / Fremont

3 month block

Update - 5/11/17 by J. Lin and F. Masroor

SL/F is the first real rotation away from the home base, allowing you to work with a different set of attendings who many choose to work with more as R4s on elective. 

Dr. Brian Kung is your coordinator.  The rotation usually involves 4 days of OR weekly with various attendings and 1 day of clinic.  If you have an interest in otology you can request to have more time with Dr. Kung, in plastics with Dr.Chiang, etc.  He is flexible and this rotation can be geared to what you want.  In general try not to take more than 5 days of vacation on this rotation. 

Rounding: 

You should expect to round on the inpatients at the facility that you’re assigned to for that day prior to your surgical or clinical duties (ex. OR in Fremont, you round on the patients in Fremont but not San Leandro) unless told otherwise.

OR: 

Start time is 8am. You should pre-op at least 30 minutes prior. OR’s rarely run over 5pm which allows for you to begin your trek through traffic (~50 mins back to Oakland if you leave anytime between 3-6pm). You typically do NOT have to carry the pager or respond to daytime consults when you are assisting in the OR. They put you in clinic instead. You also don't have to drive between sites to see consults during the day.

Call

Expect to be plugged in heavily into the call schedule. Works out to be 1 weekend/month (same as Oak) and 1-2 days a week. When you are on call at night you cover both San Leandro (busier as of 2016+, similar to Oak population) and Fremont (much smaller ER). Touch base with your on call staff and see if they want to be called about every little thing or not. In general, err of the side of over-communicating. If they feel like they don't need to be called or to come in, let them be the ones to decide. Especially true in the beginning when you don't know attendings as well.

 

Clinic:

Usually in San Leandro (when you are on call) but may be in Fremont or their Union City location as well. See schedule that Dr. Kung sends out.

San Francisco

3 month block

SF is a great rotation as the staff are young, easy to relate to, and enthusiastic. The pathology of patients tends to run more towards general practice. The patients can be a bit more needy than what we are used to.  The call is frequent but not as busy as in Oakland or San Leandro.  The ED staff is more independent as well.  They manage most epistaxis and peritonsillar abscess patients, and will even do flexible laryngoscopy.  They usually only call if having difficulty.  There is an agreement with the plastics service that all facial lacerations are to be repaired by them, and all facial fractures will be managed by us. The OR starts at 8:45 am, which is later than other sites to accommodate for the traffic coming into the city.  In general, you run your own service.  You round on all inpatients and see all the daytime consults.  Clinic is typically once twice a week and on average is 8-10 patients.  Your clinic starts later than other sites too.  If on Thursday, it starts at 11:00 am to give you time to get to the city after morning didactics.  If on another day during the week, it starts at 9:00 am.  

Faculty

- Dr. Tang is graduate of our residency program and is fellowship trained in laryngology

- Dr. Mui is a graduate of our program, the chief of the department, the residency site coordinator, and does a breadth of surgeries including blepharoplasties, DCRs

- Dr. Shen is fellowship trained in pediatric otolaryngology

- Dr. Zemo is a graduate of our program and does general practice including head and neck

- Dr. Epstein is fellowship trained in rhinology

- Dr. Gupta does most of the head and neck and endocrine surgeries there

Hospital

Located at 2425 Geary Blvd. San Francisco, CA 94115.

Clinic

Located at the French campus, located at 450 6th Ave. San Francisco, CA 94118.

The MAs block part of your schedule so you can take care of inpatients/consults. 

Elective

1 month

This is a preview of the 4th year rotation. See below.

Research

1 month

 

R4 Rotations 

Oakland Float

The land of milk and honey.  You make your own schedule.  Except for one clinic a week, you are in the OR the other 4 days. Your clinic schedule is at your discretion (most of us do it on Mondays or Thursdays) and is your own clinic with your own pts (usually 15-20 pts daily)

 

As for the OR, you will be asked to cover the cases that the PGY5s do not claim.

In general, besides Oakland, check Richmond (RCH), Hayward (HAY), Fremont (FRE), WCR, and San Rafael (SRF). 

In addition, depending on the other R4 and 5 - you can also see if secondary rooms are uncovered at Redwood City (RWCHSP) and San Francisco (GEARY). 

 

You will learn which staff you enjoy operating with and what types of cases you like. 

 

Redwood City

3 months

Redwood City is a sample of what life is like in private practice.  The hours are great (generally from 8:30 to 3-4), the call is light, the patients are friendly, Liza (the team mother - 650-299-2570) is the best. Dr. Tran is your coordinator.

In general, you are in clinic every Wednesday and Friday, with your clinic frequently being held for add on OR cases (Liza will usually take care of this).  

The clinic is located on the 4th floor.  Your clinic is a combination of pre-operative H&Ps (so you meet your cases for the coming week in clinic) as well as new patients. 

The main drawback of this rotation is the drive - route information in the details section below.

 

You are in charge of the inpatient service (which is usually minimal) and see them before clinic or OR (8:30 start time).  The staff treat you like another attending and you are expected to function as such.

 

Research

1 month

 

R5 Rotations

Oakland Chief

6 months

Oakland Float

3-6 months

RWC

(Optional) 3 months

 

Facility Details

Oakland

OR Locker (Men's):

OR Locker (Women's):

Alameda Hospital

2070 Clinton Ave., Alameda, CA 94501 (approximately 20 minute drive from Kaiser Oakland)

OR and PACU on 2nd Floor - Free green scrubs

Doctor's lounge on 1st floor - Free snacks and drinks

Dictation number and Attending ID number in dictation booths - dictate under attending name

No access to Kaiser CIPS or Healthconnect so good idea to get discharge meds and follow-up set up prior to OR day

 

Richmond

 

Main operator 307-1500, ED 307-1722

 

The OR is located on the 2nd floor.  Richmond combination: 948010

Free light blue scrubs (same as Oakland)

Dictation using same number as Oakland, but will need to activate ID

Directions: Take 580 north to San Rafael/Point Richmond. Exit to Harbor Way North. Go straight on Harbor until you reach McDonald's or Nevins. Make a left on either street. You will see a 4 story parking structure and the parking is free. If in the middle of the night, I wouldn't recommend stopping at stop signs or lights - you are in the concrete jungle.

Redwood City

Main operator 650-299-2899, ED 650-299-2201, Clinic 650-299-2570 (or 5059), OR 650-299-3136 or 2360

 

The OR is located on the 2nd floor.  

 

To check voicemail, dial 5771, follow voice prompts, passcode is 1111

 

Directions: Several options for the commute, all of which made better by leaving EARLY (before 6:30 am) and bringing some reading and camping out in the HNS clinic.

To:

1)  Bay Bridge to 101S, off at the Whipple Ave/Redwood City exit. Straight ahead (Veteran's Blvd) until you pass K-RWC and reach the (free) parking garage on R. This is usually a good option if you leave early but the 101 can become crowded (esp around I-92)

2)  880S to San Mateo bridge, then down 101S and same as above.  880S has a carpool lane but there are always bottlenecks at I-238 and the San Mateo bridge on-ramp. 

3)  880 S to Dumbarton bridge. Bypass the signs to north 101, and continue straight on the road that runs by the Sun Microsystems campus. This road is a shortcut that winds several miles through a residential area. You will eventually come to a road that crosses under Hwy 101 and intersects Veteran’s Blvd, which you will take north several blocks to the hospital on the left. Park in the same garage on Veteran’s

 From:

Same as above.  The one variation is that I would avoid the 101N inside the city like the plague (esp around Cesar Chavez).  Take the 280N (after Candlestick) and loop around onto the 6th street exit (in South Beach).  From here you have several options to get back onto the Bay Bridge (ramps at 5th and Bryant, Front and Folsom, etc.)

Also, if you elect to take San Mateo you may also exit on Hesperian/Union City Blvd (before the 880 interchange) and take this north and cross back onto 880 at Winton, A street, etc.

San Rafael

Moh’s clinic – 1st floor across the hall from Dermatology (follow the purple tiles)

OR – located on the 2nd floor. The locker room combination is 0-4-1-5

 Dictation - rarely dictate - if you must you can use attending's id

Directions: Take the 580 W (going northward). The highway splits two lanes to the right which is the continuation of 580 W to San Rafael and Point Richmond. Take this to the 580 W across the Richmond-San Rafael Bridge.  Just past the bridge, will be a connection to the 101. Take the 101 N. Take the Freitas Parkway exit towards Terra Linda. Keep left at the fork in the ramp. Merge onto Manual T. Freitas Pkwy. Turn left onto Las Gallinas Ave. Turn right onto Nova Albion Way. Turn right onto Montecillo Rd. Try to park on the Street. The Clinic entrance is from Lot C. The Mohs clinic is the first door on the right. The Dermatology Department is the first door on the left.

San Leandro / Fremont / Union City

Fremont Main Operator 675-2778

 

Commute to Hayward and Union City takes 25 minutes from KO with no traffic (ie, never), 40 minutes or so at about 7 am. To Fremont, count on 45 minutes to an hour and 15 minutes in rush hour traffic.

Union City directions- 3553 Whipple Rd. 880 to Industrial pkwy, follow to Hesperian and turn L. Offices are in a big grey bldg on R. HNS is in A bldg. To K Hayward hospital, come out of lot, take L, head up to Bolero and go R, proceed to parking garage on L.

Fremont - 39400 Paseo Padre Pkwy. 880 to Mowry- L on Mowry, over freeway, ~3 mi. to Paseo Padre, take a R and go ½ mile and it's on L. OR in main hosp., clinic in Embarcadero, 2nd flr. Alternatively, if BART floats your boat the Kaiser Fremont BART is 7-10 minutes walking from the hospital

San Francisco

Main operator 415-833-2000

Clinic 415-833-2202

OR 415-833-3990

OR Scheduling (Jackie) - 833-3204

 

The OR is located on the 4th floor.  The men's locker room code is 4103*.  Locker#: 117 (underneath Stan's) Combination: 39-21-7 

Directions:  For Geary campus, take the Bay Bridge westward and then either take the 101N to Fell Street and across Divisadero to O'Farrell (where the garage is located), or take some variation thereof using 9th, etc.  On your way home you will figure out which cross city route is the best based on certain times of the day.

The French campus is located at Geary Blvd and 6th Ave. Follow directions as above, just continue up on block past O'Farrell to Geary. Take a left on Geary, and head across town. Basement parking, enter on 5th Avenue, park on level B.  Take the elevators for Pasteur to HNS clinic on 2nd floor